An Analysis of Predictors of Cardiac Sparing using Deep Inspiratory Breath Hold for Left Sided Breast Cancer Patients

Document Type : Research Articles

Authors

1 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India.

2 Division of Medical Physics, Max Saket, Delhi, India.

3 Medical Physics Division, Department of Radiation Oncology, Rajiv Gandhi Cancer Institute, Research Centre, Sec-5, Rohini, Delhi, India

4 Department of Radiotherapy, Rajiv Gandhi Cancer and Research Centre, Delhi, India.

5 Department of Radiation Oncology, Bagchi Sri Shankara Cancer Centre and Research Institute, Bhubaneswar, India.

6 Department of Radiation Oncology, Fortis Memorial Hospital, Gurgaon, Haryana, India.

7 Department of Dermatology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, India.

Abstract

Objective: To analyse the dosimetric benefit achieved with Deep inspiratory breath hold (DIBH) for left sided breast irradiation and to identify the factors impacting it. Methods: Between 1st January’2023 to 31st December’ 2023, 100 consecutive patients with left sided breast cancer receiving adjuvant radiotherapy and fulfilling the inclusion/exclusion criteria were enrolled in a prospective study conducted at Rajiv Gandhi Cancer Institute and Research Centre, New Delhi. Two radiotherapy plans (DIBH/Free breathing (FB)) were generated and evaluated for each patient. Plans were evaluated using dose-volume histogram (DVH). Anatomical and treatment parameters predicting cardiac sparing were generated. Result: DIBH led to improvement in dosimetry for lung and cardiac structures for all group of patients. Breathhold technique showed a significant increase in the circumference of the chest, separation and heart height. An approximately 45% increase in ipsilateral lung volume was seen with DIBH. It led to a reduction in the heart volume by 17.67%. After placement of the tangential fields, a decrease in maximum heart distance (MHD) and heart volume in treatment field (HVIF) was seen in the DIBH phase. Conclusion: DIBH appears to be a useful tool for limiting cardiac and pulmonary dose in all the patients with left sided breast cancer, potentially reducing long-term complications.

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Asian Pacific Journal of Cancer Prevention
Volume 26, Issue 2
February 2025
Pages 631-638

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History

  • Receive Date: 09 October 2024
  • Revise Date: 23 December 2024
  • Accept Date: 16 February 2025

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